• Title/Summary/Keyword: Moral Distress

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Nurses' Experiences of the COVID-19 Crisis (COVID-19 위기상황에 대한 간호사의 경험)

  • Lee, Jung-Hoon;Song, Yeoungsuk
    • Journal of Korean Academy of Nursing
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    • v.51 no.6
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    • pp.689-702
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    • 2021
  • Purpose: This study aimed to develop a situation-specific theory to explain nurses' experiences of the COVID-19 crisis. Methods: The participants were 16 hospital nurses who experienced the COVID-19 crisis. Data were collected through in-depth individual interviews from September 2, 2020 to January 20, 2021. Transcribed interview contents were analyzed using Corbin and Strauss's grounded theory method. Results: A total of 38 concepts and 13 categories were identified through an open coding process. The core category found was becoming a pioneering nurse who turns crises into opportunities. The causal conditions were the chaos of being exposed defenselessly to an unexpected pandemic, fear caused by a nursing care field reminiscent of a battlefield, and moral distress from failing to protect patients' human dignity. The contextual conditions were feeling like the scapegoat of the hospital organization, increasing uncertainty due to the unpredictable state of COVID-19, and relative deprivation due to inappropriate treatment. The central phenomenon was suffering alone while experiencing the dedication of the COVID-19 hero image. The action/interactional strategy were efforts to find a breakthrough and getting the nurse's mind right, and the intervening conditions were gratitude for those who care for broken hearts and getting used to myself with repetitive work. The Consequences were becoming an independent nurse and frustration with the unchanging reality. Conclusion: This study provides the foundation for the nurse's situation-specific theory of the COVID-19 crisis by defining the crisis perceived by nurses who cared for COVID-19 patients and suggesting types of coping with the crisis.

A Review on the Change of Health Policy Based on Ethical Issues (윤리적 쟁점을 중심으로 한 보건의료정책 변화의 고찰)

  • Lee, Dong Hyun;Kim, So Yoon;Sohn, Myongsei
    • Health Policy and Management
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    • v.28 no.3
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    • pp.222-225
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    • 2018
  • Health policy is a historical product in the process of development, including the political and economic factors of the state as well as the social and cultural elements of the country. Bioethics began to debate the ethical questions that arise in the overall process of life's birth and death, and gradually evolved by presenting ethical directions for various social phenomena. Especially, according to the moral awakening of 'scientific medicine' which caused in some human problems in the rapidized scientific society from the late 19th century to the early 20th century, as a result of distress including the concept of various social relations, it is possible to say that it has reached the bioethics. Although health policy and bioethics are different in terms of starting and concept, they can be found in common with social, cultural, and political diversity in the times. In 2004, 'Bioethics Law' was enacted through the issue of research ethics in the life sciences. Therefore, in order to examine ethical aspects of current health policy direction and major issues, it can be divided into before and after enactment of 'Bioethics Law' in 2004. The authors would like to examine how the evolution of the ethical viewpoint on the health policy has changed in line with the enactment of the 'Bioethics Law' and how it is trying to solve it from an ethical point of view. Through the various events that took place in the 1990s and the 2000s, various discussions on bioethics were conducted in Korea. Prior to the enactment of the 'Bioethics Law,' ethical judgments of professions, distribution of healthcare resources, if the discussion focused on the ethical judgment of abortion, and the various events that appeared in the early 2000s became the beginning to inform that the ethical debate about the life, death, and dignity of human beings began in earnest in Korea with the enactment of the 'Bioethics Law.' Since then, 'Hospice and Palliative care Law' which was enacted in 2017, is based on the fact that the health policy of our country focuses on the treatment of the past diseases, health promotion, and delivery of health care services. It was an opportunity to let them know that even the quality problems were included. Therefore, considering the various circumstances, the ethical issue facing Korea's health care system in the future is the change of the demographic structure due to aging and what is to be considered as the beginning and the process of life in the overall process of life. It is the worry about how to die and when it sees as death. This has far exceeded the paradigm of traditional health care policies such as disease prevention and management and health promotion, and calls for innovative policy response at the national level that reflects the new paradigm, which in many cases creates a predictable ethical environment. And health policy should be shifted in the direction of future ethical review considering sustainability in the development process of future health care rather than coercive management.